Active NPI
Gabriel Mannarino, DDS
- General Practice Dentistry
- Burlington, VT
National Provider Identifier
1730396060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 018656
- Practice address
- 27 N Willard St
Burlington, VT 05401-3312 - Phone
- (802) 862-8625
- NPI assigned
- May 17, 2007
- Last updated
- May 12, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 018656 | MI | Primary |
Addresses
Primary practice location
27 N Willard St
Burlington, VT 05401-3312
Mailing address
467 Westview Cir
Williston, VT 05495-7352
Phone (313) 300-8995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018656 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willard Street Family Dental | Past | Accepting new patients | |
| Barclay & Fersing Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Burlington, VT
- NPI 1447248919
-
- Dentist
- Burlington, VT
- NPI 1427226380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242086400000",
"number": "1730396060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "467 WESTVIEW CIR",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054957352",
"telephone_number": "313-300-8995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 N WILLARD ST",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054013312",
"telephone_number": "802-862-8625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNARINO",
"first_name": "GABRIEL",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2009-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "018656",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.